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. 2013 Dec;34(9):1656-9.
doi: 10.1097/MAO.0b013e3182a006b6.

Subtotal petrosectomy and mastoid obliteration in adult and pediatric cochlear implant recipients

Christopher F Barañano  1 , Jonathan C Kopelovich, Camille C Dunn, Bruce J Gantz, Marlan R Hansen
Affiliations

Subtotal petrosectomy and mastoid obliteration in adult and pediatric cochlear implant recipients

Christopher F Barañano et al. Otol Neurotol. 2013 Dec.

Abstract

Objective: To investigate the effect of subtotal petrosectomy and mastoid obliteration (SPMO) on the overall success of adult and pediatric cochlear implant (CI) recipients.

Study design: Retrospective case series.

Setting: Tertiary care referral center.

Patients: Thirty-nine ears in 36 patients (23 adults and 13 children) received both surgeries between 1990 and 2012.

Intervention: CI candidates underwent SPMO to permit implantation and minimize the risks of infectious complications in the recipient ear. SPMO was performed before (69.3%), at the time of (25.6%), and after CI (5.13%). Mastoids were obliterated with fat (30.8%), muscle (66.7%), and bone pate (2.56%).

Main outcome measure: Feasibility, complications, and success of SPMO and CI were assessed with standard statistical analysis and Fisher's exact test with 2-sided p values.

Results: Ear disease was definitively managed, and CI was successfully placed in all but one case. Complications including abscess (n = 3), subcutaneous emphysema (n = 1), ear canal granulation formation (n = 1), and electrode extrusion (n = 1) occurred in 15.4% of patients. Predisposing syndromes were present in children more often than adults (43.8% versus 13.0%, p = 0.0598). Adults more often than children had previous mastoid surgery for middle ear disease (30.4% versus 0.0%, p = 0.0288). CIs were placed under local anesthetic and sedation (n= 3) and after radiation treatment for nasopharyngeal cancer (n = 2) in adult ears.

Conclusion: SPMO is an effective and safe procedure for definitively managing middle ear disease and implanting adult and pediatric CI candidates.

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